In healthcare facilities, “clean” does not mean “disinfected”, and “disinfected” does not mean “sterile”. The three operations have different objectives, use different products and follow a fixed sequence. Romanian Ministry of Health Order no. 1761/2021 defines them and sets the rules for applying them.
In short
- Cleaning removes soil and organic matter; it is mandatory before any disinfection and does not replace it.
- Disinfection destroys most microorganisms on surfaces or skin, using an authorised biocidal product at the concentration and contact time stated in the authorisation.
- Sterilisation destroys all microorganisms, including spores; it is mandatory for critical medical devices.
What cleaning is
Order 1761/2021 defines cleaning as the preliminary, mandatory, permanent and systematic step that removes organic and inorganic soil through mechanical or manual operations, using physical and/or chemical agents. Cleaning reduces the microbial load, but it is not disinfection: the Order states that it does not replace disinfection.
Its role is decisive for the next step. Proteins, blood or grease left on a surface consume the active substance and shield microorganisms. This is why European standards test disinfectants under “clean conditions” (0.3 g/L albumin) and “dirty conditions” (3 g/L albumin): a product that is effective under clean conditions may lose efficacy on a soiled surface.
What disinfection is
Disinfection is the procedure that destroys most pathogenic or non-pathogenic microorganisms on surfaces, including skin. It is carried out only after cleaning, using biocidal products authorised by the Romanian National Commission for Biocidal Products, applied strictly as per the authorisation: concentration, method of application and contact time.
The Order distinguishes three levels of disinfection (high, intermediate and low), depending on the microorganisms destroyed, and two moments: routine (concurrent) disinfection, performed regularly during activity, and terminal disinfection, performed after the patient is discharged or the room is vacated. We cover the levels in detail in the article High, intermediate and low-level disinfection.
What sterilisation is
Sterilisation destroys all microorganisms, including bacterial spores. It is mandatory for critical medical devices, those that enter sterile tissue or the vascular system. The Order is explicit: high-level disinfection cannot replace sterilisation.
Quick comparison
| Step | Objective | What is used | Examples of application |
|---|---|---|---|
| Cleaning | Removing soil and organic matter | Detergents, enzymatic detergents, mechanical action | Floors, furniture, washrooms; pre-cleaning of instruments |
| Disinfection | Destroying most microorganisms | Authorised biocidal products (PT2 surfaces, PT1 hands, PT4 food area) | Surfaces in wards and treatment rooms, non-critical and semi-critical devices |
| Sterilisation | Destroying all microorganisms, including spores | Pressurised steam, other validated processes | Surgical instruments, critical devices |
The correct order, step by step
- Clean: remove visible soil with detergent and mechanical action. For instruments, use an enzymatic pre-cleaning detergent.
- Rinse, if the procedure or the product requires it.
- Disinfect with a product authorised for that surface, at the concentration stated in the authorisation, and observe the full contact time.
- Rinse or leave to dry, as per the label.
- Sterilise critical devices, after cleaning.
- Record the operation in the room’s cleaning and disinfection schedule.
Common mistakes
- Disinfectant applied to a visibly soiled surface without prior cleaning.
- Shortened contact time: the surface is wiped or used before the time stated in the authorisation has elapsed.
- Mixing two products, which the Order prohibits (it can reduce efficacy or release toxic gases, e.g. chlorine in contact with acids).
- Using a product for an application not listed in its authorisation.
- Confusing “sanitising” with disinfection: a product without a biocide authorisation cannot be used as a disinfectant.
Frequently asked questions
Can cleaning replace disinfection?
No. Romanian MoH Order 1761/2021 explicitly states that, in healthcare facilities, cleaning does not replace disinfection. It prepares for it.
Can I use a detergent-disinfectant in a single step?
An authorised detergent-disinfectant combines both actions, but heavily soiled surfaces require prior cleaning. Observe the concentration and contact time in the authorisation to obtain the intended effect.
What is the difference between routine and terminal disinfection?
Routine disinfection is carried out regularly during daily activity. Terminal disinfection is carried out after the patient leaves or the room is vacated, and covers all surfaces in the room.
GM 2000 products for this application
Concentrated detergent-disinfectant (PT2) for surfaces, including walls and floors.
View product sheet →Chlorine-releasing tablets (PT2, PT4), sporicidal according to the authorisation.
View product sheet →References
- Romanian Ministry of Health Order no. 1761/2021 approving the Technical Rules on cleaning, disinfection and sterilisation in public and private healthcare facilities, Annex 1.
- Regulation (EU) No 528/2012 concerning the making available on the market and use of biocidal products.
- EN 14885: application of European Standards for chemical disinfectants and antiseptics.
Article reviewed by the GM 2000 technical team. Last updated: 22.10.2026. Product information is taken from the authorisations issued by the Romanian Ministry of Health; for other applications, refer to the label and the technical data sheet.
Use biocides safely. Always read the label and product information before use.
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